Provider Demographics
NPI:1376930842
Name:ABU, ANJU (MBBS)
Entity Type:Individual
Prefix:
First Name:ANJU
Middle Name:
Last Name:ABU
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 FANNIN ST STE 1014
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-5301
Mailing Address - Country:US
Mailing Address - Phone:832-325-7080
Mailing Address - Fax:713-512-7146
Practice Address - Street 1:6410 FANNIN ST STE 1014
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-5301
Practice Address - Country:US
Practice Address - Phone:832-325-7080
Practice Address - Fax:713-512-7146
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS19642084N0600X
TXBP200579112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology